Part D... What's the catch?

[pb4uski]

So RetMD21's post in the My "Best" Medigap options thread with a link to the Medicare Plan comparison tool caused me to do a quick compare of our Part D options for 2024, fully expecting that our current plan would still be the best option because it was when I did the same comparison last year.

For 2023 we have SilverScript SmartSaver (PDP) plan that has an $8.40/month premium (vs $7.70/month in 2022) and estimated drug and premium cost of $118.78 for the year 2023. That was the lowest cost plan avaiable in 2023 and covered all my prescriptions.

For 2024, this SilverScript SmartSaver (PDP) increases to $13.30/month (58% increase!) and has estimated drug and premium cost of $159.60 for the year. For 2024 SilverScript SmartSaver (PDP) is the second lowest cost plan.

For 2024 the Wellcare Value Script (PDP) plan is the lowest cost plan with a $0 premium and $0 estimated drug and premium cost. In 2023 the same plan (same plan name and number S4802-146-0) had a $11.20/month premium and a $149.40 estimated annual drug and premium cost and was the second lowest cost plan.

So I'm mulling changing to the $0 cost plan and saving an estimated $159.60 in 2024, but am wondering... what is the catch? And why is it $0 for 2024 and was $11.20/month in 2023?

The incumbent SilverScript SmartSaver (PDP) has 3 stars and the challenger Wellcare Value Script (PDP) has 3-1/2 stars.

Thoughts? (other than why I would start a thread to save $159.60? )

What's the catch?

 

[wmc1000]

We had Wellcare basic part D for the last few years and it is going from $10.60 per mo. in 2023 to zero in 2024. Since our meds are primarily generic, most of them are free or no more than $15 for a 3 mo. supply. In 2024 the $15/qtr. drugs will be going to $12/qtr. so that cost is reducing also.

 

[CincyDave]

See my post 11 in below thread. From what I can see my wellcare value scripts premium is going from $11.20 to $0 and my scripts are free.

https://www.early-retirement.org/forums/f38/wellcare-for-part-d-119642.html

 

[wolf]

I think Wellcare for 2024 has a higher deductible.

For people with Tier 1 drugs only. Not affected. (my wife). Save $

Myself. Tier 5/6 drug. I pay the higher deductible.

I think this is the catch:

Zero to no premium. (2024 California $ 0.40 prem). Attracts a lot of new
customers. If you only have Tier 1 drugs. Huge savings.

Then, like me. During the year. Md prescribes new drug. ie. Jardiance.
I think a tier 5/6 drug. Now Deductible kicks in. Now Well care makes
a profit.

Just my IMHO.

 

[wmc1000]

The Wellcare yearly drug deductible does increase from $505 in 23 to $545 in 24.

 

[wmc1000]

Then, like me. During the year. Md prescribes new drug. ie. Jardiance.
I think a tier 5/6 drug. Now Deductible kicks in. Now Wellcare makes
a profit.

Just my IMHO.

Yes, Jardiance on the Wellcare Value Script plan would cost $807 for the year as I have a friend that takes it and he had me check for his best option.

 

[target2019]

If you are taking generic drugs, or none at all, then obviously you can save.

But what I suggest is that companies may offer a get-started deal in order to become top dog. We can't know the future, but the trajectory for healthcare costs is upward.

Sometimes less turns into more when you get further down the road, right?

I'll do the comparison myself, and see what the difference is when you have many drugs.

 

[CRLLS]

I think that the Medicare website does a good job of showing that various companies and costs based on YOUR prescriptions. The good part about Part D is that unlike the supplements for Part B, switching plans every year does not require underwriting. So if you end up mid-year needing a new long-term prescription, it only lasts a few months before you can move to another plan. I have had WellCare for a couple of years. For one-time prescriptions, I compare my WellCare price with GoodRx and others. if the cost is to my advantage. It sometimes is, saving me $10 or $20. Fortunately, I have no long term prescriptions (yet).

 

[wmc1000]

If you are taking generic drugs, or none at all, then obviously you can save.

But what I suggest is that companies may offer a get-started deal in order to become top dog. We can't know the future, but the trajectory for healthcare costs is upward.

Sometimes less turns into more when you get further down the road, right?

I'll do the comparison myself, and see what the difference is when you have many drugs.

Yes, that is why we check every year to see if we need to change our insurance provider whether our drugs have changed or not. About 3 years ago, it made sense for DW to be on a different plan than I was to save a few bucks.

Also, I always check out the Walmart $4/$10 drug list as the 1 drug DW takes would be $129/yr. on Wellcare Value and we go to Walmart and pay only $40/yr. by not running through Part D plan. The amount doesn't go towards the deductible in this case but, she doesn't hit her deductible anyway.

 

[pb4uski]

Yes, Jardiance on the Wellcare Value Script plan would cost $807 for the year as I have a friend that takes it and he had me check for his best option.

I did previously take Jardiance and lost a lot of weight while on it. At my last physical about a year ago I changed to Glimepiride which was much cheaper. At my spring checkup the Glimepiride seemed to be doing its job, but nos well as the Jardiance... so we are still monitoring and will discuss at my annual checkup in November.

I did add Jardiance to my drug list as a test in case my PDP puts me back on it and with the $0 premium Wellcare plan the annual cost would still be the lowest, albeit $902.56 annually.

But $902.56 is still lower than the second lowest plan that is $1,252.36 annual cost and also better than my current plan SilverScript plan that would be a whopping $2,074.10 annual cost.

BTW, there may be a generic version of Jardiance available in 2024.

 

[pb4uski]

If you are taking generic drugs, or none at all, then obviously you can save.

But what I suggest is that companies may offer a get-started deal in order to become top dog. We can't know the future, but the trajectory for healthcare costs is upward.

Sometimes less turns into more when you get further down the road, right?

I'll do the comparison myself, and see what the difference is when you have many drugs.

Yes, all my drugs are pretty generic, hence the $0 annual estimated drug and premium cost.

It did cross my mind that perhaps they lowered the price to $0 to try to cture more market share.

I usually do this comparison annually and usually pick the plan with the cheapest annual drug and premium cost.

 

[aja8888]

15 years now buying Part D for me and DW (when she was alive).

I probably changed plans 10 times over those years and with DW, who took over a dozen meds, some VERY expensive, it was always a challenge to get the lowest *combined* drug price in a plan.

Oh, and drug companies can drop or change drugs during the year to complicate pricing matters.

Right now, a friend of mine buys his Jordance (SP?) diabetes drug through a Canadian pharmacy where it is shipped to him from India.

 

[target2019]

Yes, all my drugs are pretty generic, hence the $0 annual estimated drug and premium cost.

It did cross my mind that perhaps they lowered the price to $0 to try to cture more market share.

I usually do this comparison annually and usually pick the plan with the cheapest annual drug and premium cost.

$3,652.73 yearly cost for SilverScript PDP

$3,522.83 yearly cost for Wellcare Value Script PDP

$130 savings if I change to Wellcare.

 

[wolf]

Yes, Jardiance on the Wellcare Value Script plan would cost $807 for the year as I have a friend that takes it and he had me check for his best option.

Well Care:

Buying Jardiance at Costco vs Safeway. Save approx. $ 89 for the 2024 yr.

Watch out for the "donut hole". This fooled me. Your out of pocket expense
is not used to calculate ($ 4660, 2023 yr) when you enter the donut.

ie. The out of pocket expense are the "retail" prices the drugs cost.

Which is why. Using Jardiance. Medicare.gov. Part D. WellCare shows this:

January $ 578.00
April 33.00
July 33.00
Oct. 289.70 In Oct, I will have hit the "Donut"


Jardiance, 90 day. refills.
Other Tier 1 drugs. My cost $0. BUT Insurance adds in the retail price.
so you hit "Donut" quickly.

Hope that makes sense....

Will be nice if Jarniance becomes Generic in 2024. Heard it's on the list
to be negotiated.

 

[target2019]

From another thread, it was suggested that once you're a customer of Wellcare (or any provider) they can solicit you for Medicare Advantage. I don't know if that holds water.

Thinking of a solar-powered shredder you can attach to the mailbox at the curb. Lol.

 

[EastWest Gal]

From another thread, it was suggested that once you're a customer of Wellcare (or any provider) they can solicit you for Medicare Advantage. I don't know if that holds water.

Thinking of a solar-powered shredder you can attach to the mailbox at the curb. Lol.

Thanks for that! We are starting to look at Medicare (Medigap and part D) as DH goes on Medicare in January and me in September. Wellcare is so much cheaper for part D for both of us. DH is only on Simvistatin and the copay is $0 on Wellcare.

We've already received tons of mail and phone calls trying to sell us on Medicare Advantage. Fortunately we keep the recycling bin in the garage next to the door into the house, and always make a stop at the recycling bin before bringing in the mail.

 

[marko]

From another thread, it was suggested that once you're a customer of Wellcare (or any provider) they can solicit you for Medicare Advantage. I don't know if that holds water.

Thinking of a solar-powered shredder you can attach to the mailbox at the curb. Lol.

I was the OP on the other Wellcare thread last week wondering how they're able to offer a $0.50 premium.

The main input that I thought valid is that the drop in premium was due to the "inflation reduction act" and that the gov't picks up 3/4 of the cost to begin with.

As far as being solicited for MA, well, they'll have to get in line....I get about 3 a day from every Tom, Dick and Harry (not to mention every other commercial on TV), so I'm not sure that's their prime motivation.

FWIW both DW and I signed up with Wellcare yesterday

 

[pb4uski]

Thanks for all the input. I had previously scheduled a call with Boomer Benefits to see if our Medigap Plan G premiums were competitive and go over Part D.

It turns out that our current issue age plans are still competitive enough that I don't feel compelled to switch and go through underwriting.

She then steered me to the Plan D finder tool in the Boomer Benefits client portal and the best plan for me and DW was the $0 Wellcare Value Script (PDP) plan. My meds will only be $36/year but hers, which includes Jardiance, will be $965 but is still the lowest cost available.

I figure that if Boomer Benefits is selling this plan then it must be legit enough.